ASK DR ZAK

Question: Can dads get baby blues? My partner was really looking forward to the birth of our first child, but six weeks later he seems withdrawn and hardly interacts with me or our little girl – Laura, 32.

Answer: The arrival of a new one can be a time of great joy, but also a massive upheaval. If your partner has been used to a relatively commitment-free life beforehand, the realisation that having a baby is not plain sailing can often be a shock to the system. If lack of sleep is also an issue, this can make any feelings worse. Although traditionally assumed to only affect women, it is increasingly recognised that postnatal low mood may afflict fathers too. If you haven’t already, it would be worth talking to him finding out what is upsetting him. If he is really struggling, a consultation with his regular GP would be an important first step.

Question: My husband and I have been trying for a baby for two years. We’re in our mid-thirties and both healthy. My husband was told he has a low sperm count and now he’s devastated that he might not get to be a father - Cheryl

Answer: As you mention, you have been trying for two years, which is a good time to seek help. There are many risk factors for low sperm, including lifestyle choices as well as physical conditions, but in the majority of cases, no clear cause is found. Having no sperm whatsoever would stop your husband from becoming a biological father. A low sperm count may be helped by In Vitro Fertilisation (IVF), which involves taking an egg from the woman and injecting it with semen in a laboratory setting. The fertilised egg is then replaced in the woman’s womb to hopefully grow.

Don't ignore shortness of breath

OFTEN symptoms or ailments are ascribed to “just old age”, but breathlessness shouldn’t be one of them, according to Heart Valve Voice, the UK’s leading charity for heart valve disease.

It argues that awareness of heart valve disease is low, compared to conditions such as dementia and cancer, yet if ignored heart valve disease has worse survival rates than cancer.

Heart valve disease is associated with advancing years. Current figures estimate that it affects seven per cent of those over 65 and almost double that in the over 75 age group, with these figures rising as the population lives longer.

The heart has four chambers, two upper atria, and two lower ventricles. Blood flows through the heart and out in a coordinated manner thanks to one-way valves between the chambers. The heart is like any continuously running engine, and with time the valves may suffer wear and tear. If a valve becomes narrowed, known as stenosis, blood will struggle to get through it at a sufficient rate. When a valve becomes unable to shut completely, some blood may go backwards, against the intended direction of flow. This is called regurgitation, often referred to as a “leaky valve” in layman’s terms.

The most common form of heart valve disease is aortic stenosis, where the valve between the left ventricle; the main pumping chamber, and the aorta, the body’s major blood vessel, becomes narrowed. The body literally gets starved of its blood supply, but because stenosis is usually a gradual procedure, individuals may initially report no symptoms.

The symptoms of heart valve disease include breathlessness, chest pain or tightness, dizziness or fainting. If these symptoms are made worse by exertion, this is even more suggestive of a potential heart condition and Heart Valve Voice is urging anyone with any of the above not to ignore them. Even fatigue or “just feeling old” may be a symptom of heart disease.

Your first port of call is your routine GP, for a discussion of your symptoms and physical examination. Normal heart sounds are described a “lub-dub”, but a diseased valve will produce a murmur, heard with the doctor’s stethoscope. If your GP suspects heart valve disease he or she will refer you to a specialist for an echocardiogram, a scan which visualises the heart in the same way that a baby is seen while in the womb.

Mild heart valve disease may be observed with regular echocardiograms to assess for worsening, but for significant heart valve disease, repair or replacement of the diseased valve(s) is recommended in most cases. Traditionally this was a major operation requiring the breastbone to be divided to access the heart. Newer techniques referred to as minimally invasive surgery use smaller cuts, while TAVI, or Transcatheter Aortic Valve Implantation, is a procedure which only needs a small incision in the groin with the new valve being passed up through your circulation to the correct position. Overall outcomes are excellent, with patients describing a new lease of life, so please do not let fear stop you seeking help.

www.heartvalvevoice.com

If you have a question for Dr Zak, please email: askdoctorzak@gmail.com

W: doctorzak.co.uk

T: @AskDoctorZak

Dr Uddin’s advice is provided in good faith and in accordance with currently accepted evidence. However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.